A&E may move solely to major hospitals

A LONG-awaited report on medical staffing will recommend full emergency services only be provided in a small number of major hospitals

According to irishhealth.com, the Hanly report, due to be published shortly by Health Minister Micheál Martin, will also raise questions about the future of speciality hospitals such as Our Lady's Hospital for Sick Children in Crumlin.

Our Lady's was the focus of media attention last week after the death of two-year-old Róisín Ruddle whose heart operation was cancelled.

While the report says that limiting emergency services to a smaller number of big hospitals 'may raise concerns about the access of patients to treatment in life-threatening situations' it argues that many of the life-saving measures in emergencies are not affected by the immediate proximity of a hospital.

It says the critical issue is early resuscitation and early access to skilled

diagnostic, medical, surgical and anaesthetic care best provided in a major hospital.

However, independent Monaghan TD Paudge Connelly, who has campaigned against the reduction of services in Monaghan General Hospital, said people in rural Ireland would not be in favour of any scaling down of local A&E services.

"The bottom line is that people want the security of an A&E. They want to have the comfort of thinking that if they are involved in an accident, help is close at hand," he said.

"The Bronagh Livingstone case, where the baby died before reaching Cavan General Hospital after being turned away from Mongahan, is a case in point," he said.

The Hanly report goes on to say that in future, a wide range of services will only be provided in a fully staffed and equipped major hospital of which there will be fewer than exist currently.

Smaller local hospitals will deal with minor injuries or illness, outpatient and day care.

Single specialty hospitals should be relocated to major hospitals and hospitals such as those dealing solely with children, obstetrics and orthopaedics should have their acute inpatient services moved to the site of a major hospital, to cut duplication and allow speedy access to specialist support.

According to the report, it will be 2013 before all of the main reform changes will be in place. It also warns that under EU law on safe working hours, hospital consultants will not be allowed to work more than an average of 48 hours a week.

Similarly, junior doctors are currently working 'dangerously long hours' and will not be permitted to work longer than an average of 58 hours a week from August next year.

The report says that the number of hospital consultants will have to be increased by 108% to 3,600 while the number of junior hospital doctors will need to be cut by 44% to 2,200.